Patient Pathway Pharmacist - Optimal Drug-related Care

Aging Clinical Trial

Official title:

Patient Pathway Pharmacist: Drug Optimisation for Hip Fracture Patients - Facilitating a Safe Patient Handover: a Descriptive Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03695081
• Other study ID #: 59475
• Status: Completed
• Phase: N/A
• Start date: September 3, 2018
• Est. completion date: June 28, 2023

Study information

• Verified date: June 2023
• Source: Sykehuset i Vestfold HF
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Medication errors represent the most common cause of patient injury and one of the most frequently reported health related deviation in Norway. The addition of a dedicated clinical pharmacist throughout the hip fracture patient pathway (patient pathway pharmacist) is believed to improve patient safety and ensure optimal drug-related patient care. The pharmacist will perform medication reconciliation at admission to hospital, medication review after surgery and assist physicians with discharge summary. Six weeks after discharge the patient pathway pharmacist will perform a second drug reconciliation and medication review. This study will assess the pharmacists' place and specific tasks in the patient pathway, describe areas where the pharmacist contribute to increased quality of care and assess the benefits and/or disadvantages experienced with introducing a patient pathway pharmacist. The estimated number of patients included is 60. Current practice will be determined by investigating the last 50 patients' medical record and a questionnaire to health care professionals involved in treatment of hip fracture patients. Data from medication reconciliation and drug review will be collected and compared to current practice. After the inclusion period, focus group surveys and/or semi-structured interviews will be executed to describe the perceived improvement in the quality of care. Primary endpoints are: 1) Medication reconciliation score at admission 2) Number of inappropriate drugs for elderly 3) Discharge summary score 4) Discharge summaries following procedure. Secondary endpoints are readmissions and mortality after 30 and 90 days. Qualitative endpoints: 1) Health care professionals experience of current drug-related practice 2) Experienced advantages and disadvantages of a patient pathway pharmacist.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 60
• Est. completion date: June 28, 2023
• Est. primary completion date: June 15, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Hip fracture patients in Vestfold county, Norway

Exclusion Criteria:

• Patients under 18 years

• Terminally ill

• Hip fracture patients who do not follow the standardized patient pathway at Vestfold Regional Hospital

• Patients who do not consent to be included in the study

Related Conditions & MeSH terms

• Aging
• Fractures, Bone
• Hip Fractures
• Patient Fall

Intervention

Procedure:
• Patient Pathway Pharmacist intervention
Medication reconciliation at admission to hospital Medication review post surgery Optimised list of drugs in the discharge summary, in accordance with hospital procedures Medication reconciliation, six weeks after discharge Medication review, six weeks after discharge

Locations

Country	Name	City	State
Norway	Vestfold Hospital Trust	Tønsberg

Sponsors (2)

Lead Sponsor	Collaborator
Sykehuset i Vestfold HF	Hospital Pharmacy Enterprise, South Eastern Norway

Country where clinical trial is conducted

Norway, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Experience of current practice	A questionnaire will be distributed to all health care professionals involved in the treatment of hip fracture patients	Prior to or during the early start of the intervention
Other	Experience of patient pathway pharmacist	Focus groups or semi-structured interviews will be performed to assess the advantages and/or disadvantages of introducing a patient pathway pharmacist.	Within three months after last included patient
Primary	Discharge summary score	In the discharge summary, the section describing drugs is scored in accordance with the national patient safety program	At discharge (estimated five days after fracture/inclusion)
Primary	Admission summary score	In the admission summary, the section describing drugs is scored. The score is adjusted from the discharge summary score to fit the admission note.	At hospital admission (estimated to be within 24 hours after fracture)
Primary	Discharge summaries written in accordance with procedure	In the discharge summary, the section describing drugs should be in accordance with procedure.	At discharge (estimated five days after fracture/inclusion)
Primary	Number of inappropriate drugs at discharge	After surgery the medication review may reduce the number of inappropriate drugs (on the STOPP-list).	During hospitalisation, after surgery (estimated to be within five days after fracture/inclusion)
Secondary	Readmission	Patients who are readmitted to hospital is quantified	30 days after discharge
Secondary	Readmission	Patients who are readmitted to hospital is quantified	90 days after discharge
Secondary	Death	The number patients who dies is quantified	30 days after discharge
Secondary	Death	The number of patients who dies is quantified	90 days after discharge

External Links

•   Score of the drug section in discharge summaries - The Norwegian Patient Safety Programme: In Safe Hands